On a conference call working out the details of a brochure about fertility and family building for gay men affected by HIV, something was nagging at me. Eventually I asked the question, "But what do we actually mean by 'men'?" The call was silent for a minute as we all thought about it. "When we're talking about gay men or 'men' in the context of family planning, fertility and reproductive technology, do we mean people who identify as men, or do we mean bodies that produce sperm? Because if we mean 'men' as a signifier, we also have to talk about fertility options for trans men, and if we mean 'bodies that produce sperm,' we also have to talk about trans women. Either way, the language is more complicated."
A lot of these "Best of ..." or "Top Stories in ..." lists have already been published, as they seem to be appearing earlier and earlier each year. Pretty soon we'll start reading them around the same time they sell Halloween Candy -- and that's just too early, sorry.
A few notable ID stories out there for this remarkable convergence in our Judeo-Christian holiday calendar:
I know, I know -- you read that title and thought, "Grateful now? He must be out of his mind."
But with the (unsurprising) concession that I too felt that watching the election returns was akin to witnessing a slowly developing and incomprehensible train wreck, I remind you that the expression of gratitude is well known to make you happier. Plus, it's the season.
The morning after the election, my parents left on a road trip to Manzanar, the internment camp in central California where my family was imprisoned during World War II. My mother was born there. When I talked to them before they left, they were glad to be getting offline and out of range for a few days. They were going to scatter more origami cranes on the now empty, dusty block where my family was housed when my mother was a baby.
New person you're meeting: What to do you do?
ID Doc: I'm a doctor.
New person: Oh -- what kind?
ID Doc: A specialist in Infectious Diseases.
New person (making a face, or moving a few feet back, either to be humorous or truly frightened, or both): Yuck! Well I guess someone has to do it ...
We have not been here before. Over 50% of Americans with HIV are now over 50, and that number continues to grow. Mental health professionals treating older persons living with HIV are confronted with complex comorbidities that are just beginning to be documented and understood. When compounded by HIV, the routine medical, psychological and psychosocial stressors of aging grow more complex and present unique challenges to providers.
One of our medical school's most beloved teachers gives a wonderful lecture on how to give an effective presentation. He offers many invaluable tips for a successful talk, such as 1) Show up early; 2) Know your audience; 3) Don't read your slides; 4) Never include a slide that you need to preface by saying, "I know you can't read this, but ..."
This time, at least the "cure" news broke over the weekend, so I got to understand the science and anticipate the full range of responses and feelings before my week started.
In the late 1990s, a patient was admitted to our hospital with HIV-associated PCP. He had advanced AIDS, a CD4 cell count < 100, and was sick enough to require a temporary stay in our ICU.
Those clinical details aren't so remarkable -- "late" diagnoses of HIV still happen, and happened even more back then. What's remarkable is what happened to him before he got admitted.
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